The first case report of granular cell tumor was by Abrikossoff in 1926, the tumor has been named with more than 20 different synonyms. It is found usually in the tongue, oral cavity, and the skin. It occurs rarely in the esophagus. Esophageal granular cell tumor is a benign lesion which can be diagnosed by endoscopic biopsy. Large symptomatic lesion can be removed by polypectomy. A 29-year-old female visited our hospital for intermittent epigastric pain and anterior chest discomfort. Endoscopy showed a 0.6 *0.4 cm whitish yellow nodule in the mid-esophagus, 25 cm from the incisor teeth. Endoscopic polypectomy was performed with "O"-type rubber band for endoscopic variceal ligation(EVL). A case of esophageal granular cell tumor conformed by S-100 protein stain is reported with the review of literature.
Adult ; Biopsy ; Endoscopy ; Esophagus* ; Female ; Granular Cell Tumor* ; Humans ; Incisor ; Mouth ; Rubber ; S100 Proteins ; Skin ; Thorax ; Tongue ; Tooth

No abstract available.
Herpes Zoster* ; Intestinal Pseudo-Obstruction*

BACKGROUND: Acute liver failure either after liver resection or as part of underlying liver disease is still associated with high mortality. Various treatments have been tried to improve liver function during acute liver failure, including metabolic and nutritional support, hemodialysis, hemoperfusion, plasmapheresis, and hepatocyte and liver transplantation. Hepatocyte transplantation in various forms has attracted attention recently. We investigated whether allogeneic isolated hepatocytes transplanted in the spleen would prolong survival, facilitate liver regeneration, and improve biochemical parameters in rats with acute liver failure induced by a 90% hepatectomy. METHODS: Allogeneic male Sprague-Dawley rats were used. Group I rats (n=26) received an intrasplenic injection of 2 107 hepatocytes in 0.3 ml of Dulbecco's modified Eagle's medium (DMEM), and 1 days later acute liver failure was induced. Group II acute-liver-failure rats (n=24) received an intrasplenic injection of DMEM. The survival time was determined for 22 rats in Group I and for 20 rats in Group II. The remaining 8 (4/each group) acute liver failure rats were used to assess the liver function and regeneration. RESULTS: The survival was longer and the number of long-term survivors was greater for Group I rats than for the Group II controls. At 24 hour after the hepatectomy, Group I rats had lower ammonia, lower total bilirubin, lower activities of liver enzymes, and higher glucose levels than did Group II rats. In Group I, there was significant increase in the ratio of the weight of the remnant liver lobes to the body weight. CONCLUSION: Compared with the Control group intrasplenic hepatocyte transplantation in acute liver failure rats acts as a bridge to support experimental rats in going from acute or fulminant liver failureto liver regeneration or compensation, prolongs survival in rats with acute liver failure induced by a 90% hepatectomy, and improves the biochemical parameters, except for the albumin levels and prothrombin time. Transplantation of hepatocytes may be beneficial in supporting a liver which has been acutely devastated by a 90% hepatectomy.
Ammonia ; Animals ; Bilirubin ; Body Weight ; Compensation and Redress ; Glucose ; Hemoperfusion ; Hepatectomy* ; Hepatocytes* ; Humans ; Liver ; Liver Diseases ; Liver Failure, Acute* ; Liver Regeneration ; Liver Transplantation ; Male ; Mortality ; Nutritional Support ; Plasmapheresis ; Prothrombin Time ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Renal Dialysis ; Spleen ; Survivors

BACKGROUND: Helicobacter pylori (H. pylori) can now be eradicated in the majority of patients with 7 days of treatment with OAC (omeprazole+amoxicillin+clarithromycin) regimen. It is unclear if additional acid-suppressing treatment should be continued beyond 7 days in patients with active gastric or duodenal ulcers. METHODS: Ninety two patients with endoscopically proven active peptic ulcers who were H. pylori positive were randomized to receive either omeprazole 20 mg plus amoxicillin 1.0g plus clarithromycin 500mg ; twice daily for 1 week alone (OAC group) or same regimen followed by 3 weeks of omeprazole (OACP group). Endoscopy and UBT (urea breath test) were performed 8 weeks after the initiation of treatment. RESULTS: Forty four of forty five (97.8%) of OAC group and forty four of forty seven (93.6%) of OACP group were noted to have healed ulcer at week 8. CONCLUSION: In patients with H. pylori infection and peptic ulcers, one week of OAC therapy without further need for PPI may heal the ulcers. Following an l week course of H. pylori eradication therapy by OAC for peptic ulcers, further 3 weeks of acid-suppressing therapy with PPI was not proven to promote ulcer healing rate.
Amoxicillin ; Clarithromycin ; Duodenal Ulcer ; Endoscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Omeprazole ; Peptic Ulcer* ; Ulcer

The two most common causes of acute arterial occlusion are embolism and thrombosis in sity. They are mainly originated from the cardiovascular sources. About 70-80 per cent of occlusions occur in the axial limb vessels. Therapeutic options include supportive measures, pharmacologic treatment, surgery, and non-operative interventions. There have been several successful case reports using percutaneous aspiration thromboembolectomy with the advent of new instruments and technical imprevement. We report a case of 70-year-old male with acute anterior wall myocardial infaction who experienced acute embolic arterial occlusion of the left popliteal artery from mural thrombus in the left ventricular apex. It wan managed successfully by percutaneous aspiration thromboembolectomy.
Aged ; Embolism ; Embolism and Thrombosis ; Extremities ; Humans ; Male ; Popliteal Artery ; Thrombosis

Primary aldosteronism is present in approximately 1% of unselectd hypertensive patients. Adrenal adenoma is a known as one of the surgically curable form of the hypertension. Hypertension is one of the contributing factors for the development of aortic dissection. Cincurrence of aortic dissection in patient with primary aldosteronism is extemely rare. Only one case wasconfirmed by autopsy and reported in the world literature. We report a case of DeBakey type 3 anortic aneursm in a 49-year old hypertensive female patient with primary aldosteronism due to left adrenal adenoma. She underwent left adrenalectomy uneventfully after stabilization of her blood pressure with maximal medical management including nitroprusside, aldactone, enalapril and inderal.
Adenoma ; Adrenalectomy ; Autopsy ; Blood Pressure ; Enalapril ; Female ; Humans ; Hyperaldosteronism ; Hypertension ; Middle Aged ; Nitroprusside ; Propranolol ; Spironolactone

Arachnoid cyst develops due to cerebrospinal fluid increase in the subarachnoid space and is mostly located in the middle cranial fossa, which may be associated with non-specific symptoms such as headache, unsteadiness and ataxia. However, it rarely occurs in the posterior cranial fossa and is mostly asymptomatic. When symptoms do develop, they are usually headache and psychomotor retardation, which make diagnosis very difficult. Diagnosis is generally made through magnetic resonance imaging and surgical treatment is indicated for cases where there are displacement and compression of its surrounding neurovascular component, and aggravation of symptoms. We present a case of unilateral sudden hearing loss possibly developing from an arachnoid cyst in the posterior cranial fossa with a review of literatures.
Arachnoid* ; Ataxia ; Cerebrospinal Fluid ; Cranial Fossa, Middle ; Cranial Fossa, Posterior ; Diagnosis ; Headache ; Hearing Loss, Sudden* ; Magnetic Resonance Imaging ; Subarachnoid Space

A Cesarean section scar pregnancy is a rare but possibly life-threatening condition. The diagnosis is made mainly based on transvaginal ultrasonography. We used the Doppler and serial beta HCG in determining the severity and prognosis. Because of the rarity, universal treatment has not been established. In our cases, the severity of bleeding was independent of the level of beta HCG and the duration of amenorrhea. The shorter the interval from the previous cesarean section, the more severe the symptom, in such case, we were able to preserve fertility by uterine artery embolization. Cesarean section scar pregnancy can be managed conservatively with methotrexate injection. Based on our case review, we can conclude that it is very important that we choose the each therapeutic management based on her history and condition. In our review, we present four cases diagnosed with Cesarean section scar pregnancy all managed conservatively to preserve future fertility.
Amenorrhea ; Cesarean Section* ; Cicatrix* ; Diagnosis ; Female ; Fertility ; Hemorrhage ; Methotrexate ; Pregnancy ; Pregnancy* ; Pregnancy, Ectopic ; Prognosis ; Ultrasonography ; Uterine Artery Embolization

The Peutz-Jeghers syndrome is an autosomal dominant disease characterized by hamartomatous polyps in the gastrointestinal tract and mucocutaneous melanin pigmentation. Although these polyps are believed to have little potential for malignancy, and the disease was believed to have a relatively benign course, it recently has been recognized that patients with this syndrome are at increased risk for the development of cancer at gastrointestinal and nongastrointestinal sites. A 33-year-old male patient was admitted because of vomiting and abdominal pain for 3 months duration. A diagnosis of Peutz-Jeghers syndrome was made 3 years ago by multiple hamartomatous polyps confined to the colon and mucocutaneous pigmentation. A barium study showed abrupt string like luminal narrowing at the 4th portion of the duodenum. On laparotomy, there was an annular constricting mass involving the serosa of duodenum with multiple metastasis to liver, so a segmental resection of small bowel followed by chemotherapy was performed. The histologic finding was adenocarcinoma.
Abdominal Pain ; Adenocarcinoma* ; Adult ; Barium ; Colon ; Diagnosis ; Drug Therapy ; Duodenum ; Gastrointestinal Tract ; Humans ; Laparotomy ; Liver ; Male ; Melanins ; Neoplasm Metastasis ; Peutz-Jeghers Syndrome* ; Phenobarbital ; Pigmentation ; Polyps ; Serous Membrane ; Vomiting

BACKGROUND: The importance of the intrinsic analgesic properties of the alpha 2-agonist is difficult to establish, but many studies have shown the beneficial effect of epidural clonidine in postoperative pain management. The authors examined the analgesic effect of clonidine, a preferential alpha 2-adrenergic agonist, upon hemodynamics, and side effects during the post-operative period in patients undergoing Cesarean section. METHODS: Sixty healthy parturients undergoing Cesarean section with general anesthesia were divided into two groups as follows: 1) Epidural Morphine group: An initial dose of morphine 3 mg diluted with 10 ml of 0.125% bupivacaine was injected epidurally at time of the peritoneal closure, followed by a continuous epidural infusion of morphine 7 mg and 100 ml of normal saline for the postoperative 2 days. 2) Epidural Clonidine group: An initial dose of clonidine 150 microgram diluted with 10 ml of 0.125% bupivacaine was injected epidurally at time of the peritoneal closure, followed by a continuous epidural infusion of clonidine 1800 microgram and 100 ml of normal saline for the postoperative 2 days. Postoperative analgesia was assessed by recording the VAS (Visual Analogue Scale), PHS (Prince Henry Score) at postoperative 1, 2, 3, 6, 12, 24, and 48 hours. Blood pressure, heart rate, sedation, and side effects were also recorded. RESULTS: There were no statistically significant differences in the VAS and hemodynamic changes between the two groups, but the epidural clonidine reduced the PHS significantly at 1, 2, 3 postoperative hours (P < 0.05). There were less side effects in the cases of epidural clonidine as compared with epidural morphine. CONCLUSION: In comparison to epidural morphine, epidural clonidine produces a similar degree of analgesia but less side effects.
Analgesia ; Anesthesia, General ; Blood Pressure ; Bupivacaine ; Cesarean Section* ; Clonidine* ; Female ; Heart Rate ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Morphine ; Pain, Postoperative ; Pregnancy